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Mortality in Asian Indians with Charcot’s neuroarthropathy: a nested cohort prospective study

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Abstract

Aims

We studied mortality in individuals of diabetes with or without Charcot neuroarthropathy (CN).

Methods

People attending diabetic foot care facility with CN of foot (Cohort 1) were prospectively evaluated. Details pertaining to the duration of diabetes, microvascular and macrovascular complications, foot ulcer, amputation and mortality outcomes were recorded and compared with those without foot complications (Cohort 2) by multivariate logistic regression.

Results

Data for 260 individuals of diabetes with CN and 520 individuals without CN were analysed. Mean age at presentation with CN was 55.8 ± 9.1 years, and duration of diabetes was 12.9 ± 7.8 years. 39.8% individuals with CN had foot ulcer, and 15.3% had amputation. People with CN were younger (55 ± 9.1 vs. 59.9 ± 8.1 years, p < 0.001) and had higher prevalence of microvascular complications. A total of 39 (15%) individuals with CN and 50 (9.8%) (p = 0.03) individuals without CN died during median follow-up of 40(24–51) months. People with CN had 2.7 times (OR 2.72, 95% CI 1.4–5.2, p = 0.003) increased mortality risk when matched for potential confounders. Prevalent CAD and low eGFR predicted higher mortality in people with CN.

Conclusions

People with Charcot neuroarthropathy have almost three times increased risk of mortality despite being younger at presentation.

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Acknowledgements

We thank Miss Deeksha for data entry.

Author information

Author notes

  1. Shakun Chaudhary, Anil Bhansali and Ashu Rastogi have contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, PGIMER, Chandigarh, 160012, India

    Shakun Chaudhary, Anil Bhansali & Ashu Rastogi

Authors
  1. Shakun Chaudhary
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  2. Anil Bhansali
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  3. Ashu Rastogi
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Contributions

AR was involved in conceptualising the study, prospective follow-up, clinical care of the patients, writing and editing the manuscript. SC analysed the data and wrote the initial draft of the manuscript. AB conceptualised the study and edited the manuscript.

Corresponding author

Correspondence to Ashu Rastogi.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institute Ethics Committee.

Informed consent

A written and informed consent was obtained from all the participants of the present study.

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Managed by Antonio Secchi.

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Chaudhary, S., Bhansali, A. & Rastogi, A. Mortality in Asian Indians with Charcot’s neuroarthropathy: a nested cohort prospective study. Acta Diabetol 56, 1259–1264 (2019). https://doi.org/10.1007/s00592-019-01376-9

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  • DOI: https://doi.org/10.1007/s00592-019-01376-9

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